NEUROLOGIC MUSIC THERAPY IN COGNITIVE REHABILITATION

Whatever the hell this means.

NEUROLOGIC MUSIC THERAPY IN COGNITIVE REHABILITATION

 MICHAEL H. THAUT Colorado State University

NEUROLOGIC MUSIC THERAPY LAST CAME INTO research and clinical focus via cognitive rehabilitation. New imaging techniques studying higher cognitive functions in the human brain ‘in vivo’ and theoretical advancements in music and brain function have facilitated this development. There are shared cognitive and perceptual mechanisms and shared neural systems between musical cognition and parallel nonmusical cognitive functions that provide access for music to affect general nonmusical functions, such as memory, attention, and executive function. The emerging clinical literature shows substantial support for these effects in rehabilitative retraining of the injured brain. Key findings relevant for clinical applications of neurologic music therapy to cognitive rehabilitation are presented and discussed below. Received November 4, 2009, accepted December 14, 2009. Key words: neurology, music, cognition, rehabilitation, brain, THE ROLE OF MUSIC IN COGNITIVE rehabilitation (CR) has been the last domain to come into full focus in neurologic music therapy. Applications of music to CR were not studied well in the past in comparison to, for example, music’s role in motor therapies or speech/language rehabilitation. Several conceptual problems probably accounted for the slow research development. In reviewing the music therapy literature over the past 50 years, very few studies have examined how music can influence cognitive functions in a therapeutic context on a theoretical basis. Music cognition has of course always been a field of very active scholarship, but no conceptual links have been developed as to how cognitive processes in music perception could be transferred to retraining cognition and perception in therapy. The overwhelming reliance on broad—and often psychotherapeutically oriented— concepts of music as a therapeutic tool for models of ‘well being’ and therapeutic relationship building, as well as an intuitive but mostly undifferentiated emphasis on emotional components in the therapeutic music experience, contributed to this lack of development. Another factor that has slowed this research is more technical in nature. There were clear limitations to cognitive brain research from a neuroscience perspective before the advent of noninvasive research tools to study the human brain in vivo. Brain imaging techniques did not develop fully until approximately between 1985 and 1990, and they were slow to become available to musical brain research. Today’s wide availability of brain-imaging equipment, together with the considerable refinement in brain-wave measurement techniques via EEG and MEG, has produced a new basis for biomedical research in music cognition and rehabilitation. Links Between Music and Cognitive Functions From these efforts a growing body of research has emerged that sheds new light on intriguing links between music and a variety of cognitive functions, including temporal order learning (Hitch, Burgess, Towse, & Culpin 1996), spatiotemporal reasoning (Sarntheim et al., 1997), attention (Drake, Jones, & Baruch, 2000; Large & Jones, 1999), and auditory verbal memory (e.g., Deutsch, 1982; Glassman, 1999; Kilgour, Jakobson, & Cuddy, 2000; Thaut et al., 2005; Chan et al., 1998; Ho et al., 2003). Efforts have also been put forward to examine models how music can remediate cognitive functions. For example, a large and consistent body of research in musical attention has pointed to the role of rhythm in tuning and modulating attention in music (e.g., Drake et al., 2000; Jones, 1992; Jones, Boltz, & Kidd, 1982; Jones & Ralston, 1991; Klein & Jones, 1996 ). Rhythmic patterns entrain attention focus by interacting with attention oscillators via coupling mechanisms. Bonnel, Faita, Peretz, and Besson (2001) found evidence for divided attention mechanisms in song between processing of lyrics and processing of music. Very important connections between musical and nonmusical memory formation have been laid out by Deutsch (1982), showing how some of the fundamental organizational processes for memory formation in music—based on the structural principles of phrasing, grouping, and hierarchical abstraction in musical patterns—have their parallels in temporal chunking principles of nonmusical memory processes.